Weight gain following a diagnosis of anti-neutrophil cytoplasmic antibody-associated vasculitis

The prevalence of obesity in ANCA-associated vasculitis (AAV) has not been well documented, despite an increased risk of cardiometabolic disease in these patients. We aimed to characterize changes in weight following a diagnosis of AAV and determine risk factors for gaining weight and becoming obese. We examined data from a single-centre registry of patients with AAV, diagnosed between 2003 and 2023. We evaluated changes in weight and BMI following diagnosis and determined the prevalence of obesity. Using linear regression, we identified factors contributing to an increase in BMI at 6 months. Logistic regression was used to define predictors for obesity at 6 months. A total of 215 patients with AAV were included. Patients experienced a mean weight gain of 5.2% in the first 6 months; this was sustained for at least 2 years. A total of 69% of patients were overweight or obese at 6 months compared with 59% at baseline. Weight gain was greater following the first presentation compared with relapsing disease. Baseline factors associated with an increase in BMI at 6 months included higher eGFR [β = 0.70 (95% CI 0.36, 1.03), P < 0.001] and earlier year of presentation [β = 0.38 (95% CI 0.08, 0.69), P = 0.008]. Higher eGFR [adjusted odds ratio (aOR) 1.36 (95% CI 1.08, 2.72), P < 0.001] and baseline BMI [aOR 2.57 (95% CI 1.81, 3.64), P < 0.001] were associated with an increased likelihood of obesity at 6 months. Weight gain is common following a diagnosis of active AAV. This is now less pronounced than it was 2 decades ago. Better kidney function and higher baseline BMI are associated with a greater risk of being obese at 6 months. Many patients with AAV are likely to benefit from interventions aimed at achieving a healthy weight.